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Theories of Counseling: Cognitive Behavior Therapy

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Theories of Counseling:

Cognitive Behavior Therapy

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Cognitive Behavior Therapy

Basic Tenets

The main theories are Cognitive Behavior Therapy, Rational EmotiveBehavior Therapy and Cognitive Behavior Modification.

The way individuals structure and interpret experiences, determines theirmoods and behaviors.

Changing conceptualizations lies at the heart of cognitive behavioraltherapy.

Combines both cognitive and behavioral approaches.

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Cognitive Behavior Therapy

Basic Tenets

Cognitive therapy rests upon the belief that what one thinks determineshow one feels.

The therapist is supportive and empathic and uses experiments andempirical processes along with a collaborative alliance with the client, toexplore thinking and alternatives.

Cognitive therapy has been used with a variety of disorders and problems(e.g. anxiety, phobias, depression).

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What do

I think

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Cognitive Behavior Therapy

Theory of Personality

Personality includes both genetic endowment and social influence.

It reflects the individual’s cognitive organization and structure. 

Emotions and behaviors are based on perceptions, interpretations, andassumptions.

Schemas have an important impact on how one operates cognitively.

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Cognitive Behavior Therapy

Theory of Personality

Schemas: A person’s core beliefs and basic assumptions. 

Schemas can either be functional or dysfunctional and more than oneschema can compete with another.

Cognitive Vulnerability: When a person’s beliefs and assumptions

predispose him or her to psychological distress.

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Cognitive Behavior Therapy

Nature of Maladjustment.

Maladjustment stems from irrational beliefs and distorted cognitions.

Maladaptive cognitions come from:

Selective attention

Misperception

Maladaptive focusing

Maladaptive self-arousal

Repertory deficiencies

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Cognitive Behavior Therapy

Nature of Maladjustment.

Maladaptive cognitions lead to maladaptive, self-defeating behaviors.

 Adaptive, self-enhancing behaviors come from a client’s self -enhancingthoughts and this can be taught.

Clients can be taught to shift from self-defeating thoughts to self-

enhancing thoughts.

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Cognitive Behavior Therapy

The Counseling Process

Cognitive therapy and cognitive behavior modification uses a variety oftechniques or procedures to assist clients in changing negative, selfdefeating responses.

The therapist might range from directive to unconditionally accepting, fromscientific to empathic, from systemic to open or from suggestive toinstructive.

It is highly eclectic and utilizes resources and techniques that fit with theclient’s thought processes. 

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Cognitive Behavior Therapy

The Counseling Process

Both cognitive and behavioral strategies might be used.

Client and therapist work together:

to help the client gain cognitive and behavioral control over his or herproblem.

 to look at different ways of behaving.

to analyze thoughts and emotions.

to practice new cognitive and behavioral patterns. 

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Cognitive Behavior TherapyStrategies for Helping Clients

Beck’s cognitive psychotherapy 

The goals are to correct faulty information processing and help clientsmodify their assumptions that maintain their maladaptive behaviors andemotions.

Collaborative Empiricism: Therapist and client are co-

investigators.

Guided Discovery: Guided by the therapist, the client engages inexperiments that result in more adaptive ways of thinking.

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Cognitive Behavior TherapyStrategies for Helping Clients

Mental and Emotive Imagery

Mental Imagery is a process through which a person focuses on vividmental pictures of experiences or events—past, present or future.

Emotive Imagery: It is a procedure where the client imagines theemotional sensations and feelings of an actual situation or behavior.

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Cognitive Behavior TherapyStrategies for Helping Clients

Cognitive Modeling: Identification of what maladaptive or bad thoughts or

emotions the client wishes to be rid of and then the therapist models withself-talk that the client will incorporate.

Covert Modeling: A client imagines engaging in the desired behaviors heor she wants to learn or adopt.

Thought Stopping: Interruption of unwanted thoughts when they occur byshouting “stop” whenever the unwanted thought pops into consciousness. 

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Cognitive Behavior TherapyStrategies for Helping Clients

Cognitive Restructuring: Replacement of negative, maladaptive thoughts

with positive, adaptive ones.

Reframing: To modify or restructure a person’s view or perceptionregarding a problem or behavior.

Stress Inoculation: A process of teaching clients both cognitive and

physical skills for autonomously coping with future stressful anddistressing situations.

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Cognitive Behavior TherapyStrategies for Helping Clients

Meditation and Relaxation: Helps the client concentrate on some internal

or external stimulus that serves to focus the client’s attention away fromaversive stimuli.

Biofeedback: Uses technology to communicate to a client what his or herown body is doing and then allows that person to use mental processes tocontrol bodily functions.

Neurolinguistic programming: Using the client’s sensory language to fullyexperience the client’s inner world (e.g. I see that (visual); I feel that(kinesthetic) ; I hear that auditory).

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Cognitive Behavior TherapyStrategies for Helping Clients

Eye Movement Desensitization Reprocessing (EMDR):

Used primarily to treat traumatic memories.

The client imagines the scene, is aware of the negative statementregarding that scene (along with noxious feelings), and then followsthe therapist’s finger with his or her eyes.

Then the client erases the image from his or her mind.

This is continued over a series of steps until hopefully the painfulimage and noxious feelings and memories are removed.

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Cognitive Behavior TherapyDisadvantages of Cognitive Behavior Therapy

It has been harshly judged by feminists, multiculturalists and ecologists

because it mirrors masculine and Euro-American worldviews and doesnot adequately take culture into consideration.

It requires a lot of training and skill.

The therapist needs to not only understand cognitive techniques but also

have a vast understanding of behavioral and learning theories.

The therapist needs to have strong discipline and there is less tolerancefor error.

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Cognitive Behavior TherapyCognitive Behavior Therapy with Diverse Populations

It matches problems to treatments without regard for race or cultural

considerations.

It can be used effectively if culture and the client’s worldview is take intoconsideration.

Therapy is a collaboration and depends upon trust between counselor

and client and this can work well with culturally diverse clients.

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Resources

Ivey, A. E., D’Andrea, M., Ivey, M. B. and Morgan, L. S. (2002). Theories of counseling

and psychotherapy: A multicultural perspective, 5th ed. Boston, MA.: Allyn &Bacon.

James, R. K. & Gilliland, B. E. (2003). Theories and strategies in counseling and

 psychotherapy, 5th ed. Boston, MA: Allyn & Bacon.

Kottler, J. A. (2002). Theories in counseling and therapy: An experiential approach.

Boston, MA: Allyn & Bacon.

“Copyright © Allyn & Bacon 2004”